Concept explainer
Medication orders
Explains how a medication order captures the drug, dose, route and schedule, and how it reaches the pharmacy and the bedside.
A medication order records the drug, the dose, the route and the schedule, and carries that one instruction from the prescriber to the pharmacy and on to the bedside. This page follows a medication order through the platform, from the moment you place it to the moment a dose is given.
A medication order is placed inside one visit, against the hospital's approved catalogue. Forge carries it through its lifecycle, hands the doses to scheduling, and calls billing at the right moment.
What the order holds
You choose the drug from the catalogue and set how it is given. The order holds five things.
The approved item, frozen as it stood when you placed the order.
The amount given at each administration.
How the dose is given, such as oral or intravenous.
How often a dose falls due across the day.
How long the course runs, for a scheduled course.
A course can carry a changing dose, so a reducing regimen reads as one order. The terms you pick come from a fixed set, described in dosing vocabulary.
Ad-hoc medicine stays governed
When you add an ad-hoc medicine at the bedside, it resolves to a governed catalogue item rather than free text. So even a one-off dose carries a schedule, a safety profile and a charging path.
From order to bedside
Beside its lifecycle, a medication order carries an operational track that mirrors the real work on the ward. You place it, the ward sends it to the pharmacy, the pharmacy dispenses the strips or vials, the ward takes delivery, and the doses are given. This track sits beside the order status and stays a record of the work rather than a status of its own.
The pharmacy check applies where a site asks a pharmacist to sign the order off. The rest of the track runs on every staff-administered course. Read the whole order path in the order lifecycle.
A dose gives from ward stock
A dose becomes administerable once the drug is dispensed and received on the ward. Until then the dose waits, so the ward gives from stock that has arrived.
The dose schedule
Every scheduled dose becomes a due task with a due time. Quest holds these tasks, records the outcome of each dose, and keeps that history against the patient. Every dose closes on one of six outcomes.
| Outcome | What it records |
|---|---|
| Given | The dose was administered. |
| Held | A clinical instruction meant the dose was not given, such as a doctor's hold or nil by mouth. |
| Refused | The patient declined the dose. |
| Unavailable | The drug had not reached the ward in time, so the dose could not be given. |
| Missed | The due time passed with no outcome recorded. |
| Given in error | A dose was charted by mistake and has been corrected. |
Held, refused and unavailable each carry a reason, so the chart reads truthfully. Missed carries none, because it records the absence of an entry rather than a decision. The due list, the timing rules and the reminder cards live in medication schedules.
Safety at the bedside
Medication safety rests on checks made at the moment a dose is given, by the person giving it.
Checks at administration
The administering nurse verifies the five rights before a dose is marked given. A controlled-drug dose records a witness drawn from the on-duty roster, so the administration carries a named second nurse alongside the batch and any wastage. A high-alert drug records a second check by a second member of staff. Pensieve prepares each check, the nurse confirms it, and the record keeps who confirmed it and when.
Order-time review sits earlier. A dose above a ceiling, a documented severe allergy and a drug contraindicated in pregnancy each raise a hard stop, cleared only by a permitted clinician recording an override with a reason. Milder findings, such as a moderate interaction or a duplicate therapy, are shown for acknowledgement. The full picture sits in medication safety.
Charging a medication
Charging follows the dispense, per strip or vial issued, rather than per dose given. When the pharmacy issues a strip or a vial, Vault raises one charge for what was issued. A course dispensed twice carries two charges, each for the amount actually handed over.
Placing the order raises no medication charge on its own, so a course stopped early is billed for what left the pharmacy. See how a charge is formed in how a charge is created.
Changing a placed order
A placed order can be corrected. You can amend the dose, fix the route, change the schedule, adjust the quantity or add a clarification. The change keeps the order's status, raises its version and keeps every earlier version as history.
A schedule or dose change recomputes the doses still to come and keeps the doses already given intact. The original order stays readable through its snapshot, covered in the ordered snapshot.
The outpatient path
For an outpatient course, the ward and dispensing steps step aside. The plan and its timeline are still created, and the patient or the doctor marks the course complete. A dose from the hospital pharmacy still records a dispense and its charge; a medicine the patient buys outside the hospital records neither.
Common questions
Does a medication order bill per dose?
Charging follows the dispense. Each strip or vial the pharmacy issues raises one charge, so a five-day course dispensed twice carries two charges, for the amount actually issued.
What happens to the schedule when I change the dose?
A dose or schedule change recomputes the doses still to come and keeps the doses already given as history.
Where does a nurse record a dose as given?
A nurse records the dose against its due task on the ward. Follow the steps in record a dose.
Read how each dose becomes a scheduled task in medication schedules.